ObjectivePrimary liver cancer, predominantly hepatocellular carcinoma (HCC), is a significant global health issue, ranking as the sixth most diagnosed cancer and the third leading cause of cancer-related mortality. Accurate and early diagnosis of HCC is crucial for effective treatment, as HCC and non-HCC malignancies like intrahepatic cholangiocarcinoma (ICC) exhibit different prognoses and treatment responses. Traditional diagnostic methods, including liver biopsy and contrast-enhanced ultrasound (CEUS), face limitations in applicability and objectivity. The primary objective of this study was to develop an advanced, light-weighted classification network capable of distinguishing HCC from other non-HCC malignancies by leveraging the automatic analysis of brightness changes in CEUS images. The ultimate goal was to create a user-friendly and cost-efficient computer-aided diagnostic tool that could assist radiologists in making more accurate and efficient clinical decisions. MethodsThis retrospective study encompassed a total of 161 patients, comprising 131 diagnosed with HCC and 30 with non-HCC malignancies. To achieve accurate tumor detection, the YOLOX network was employed to identify the region of interest (ROI) on both B-mode ultrasound and CEUS images. A custom-developed algorithm was then utilized to extract brightness change curves from the tumor and adjacent liver parenchyma regions within the CEUS images. These curves provided critical data for the subsequent analysis and classification process. To analyze the extracted brightness change curves and classify the malignancies, we developed and compared several models. These included one-dimensional convolutional neural networks (1D-ResNet, 1D-ConvNeXt, and 1D-CNN), as well as traditional machine-learning methods such as support vector machine (SVM), ensemble learning (EL), k-nearest neighbor (KNN), and decision tree (DT). The diagnostic performance of each method in distinguishing HCC from non-HCC malignancies was rigorously evaluated using four key metrics: area under the receiver operating characteristic (AUC), accuracy (ACC), sensitivity (SE), and specificity (SP). ResultsThe evaluation of the machine-learning methods revealed AUC values of 0.70 for SVM, 0.56 for ensemble learning, 0.63 for KNN, and 0.72 for the decision tree. These results indicated moderate to fair performance in classifying the malignancies based on the brightness change curves. In contrast, the deep learning models demonstrated significantly higher AUCs, with 1D-ResNet achieving an AUC of 0.72, 1D-ConvNeXt reaching 0.82, and 1D-CNN obtaining the highest AUC of 0.84. Moreover, under the five-fold cross-validation scheme, the 1D-CNN model outperformed other models in both accuracy and specificity. Specifically, it achieved accuracy improvements of 3.8% to 10.0% and specificity enhancements of 6.6% to 43.3% over competing approaches. The superior performance of the 1D-CNN model highlighted its potential as a powerful tool for accurate classification. ConclusionThe 1D-CNN model proved to be the most effective in differentiating HCC from non-HCC malignancies, surpassing both traditional machine-learning methods and other deep learning models. This study successfully developed a user-friendly and cost-efficient computer-aided diagnostic solution that would significantly enhances radiologists’ diagnostic capabilities. By improving the accuracy and efficiency of clinical decision-making, this tool has the potential to positively impact patient care and outcomes. Future work may focus on further refining the model and exploring its integration with multimodal ultrasound data to maximize its accuracy and applicability.

Objective To explore the occurrence and development trajectories of symptoms at different time points in patients with acute pancreatitis (AP), and to analyze the influencing factors and preventive measures of development trajectories of AP symptom clusters. Methods A convenient sampling method was used to select AP who were admitted from January 2023 to December 2023 were selected and included in the study. The symptoms at different time points were recorded. The severities of symptom clusters in AP patients were explored, and the development trajectories of main symptom clusters were analyzed. Univariate and multivariate logistic regression analyses were used to analyze the influencing factors of development trajectories of symptom clusters in AP patients. Results The incidence rates of abdominal pain, dry mouth, abdominal distension and lack of energy were higher in AP patients during hospitalization. The incidence rates of lack of energy, anxiety, abdominal pain and sleep disturbance were higher on the 1^st month after discharge. The incidence rates of abdominal distension, abdominal pain, sleep disturbance and anxiety were higher on the 3^rd month after discharge. The incidence rates of anxiety, abdominal pain and irritability were higher on the 6^th month after discharge. The fatigue symptom cluster, psychological symptom cluster and gastrointestinal symptom cluster were extracted during hospitalization and on the 1^st month and the 3^rd month after discharge, and the psychological symptom cluster and gastrointestinal symptom cluster were extracted on the 6^th month. The severity scores of symptom clusters at each time point were statistically different (P<0.05). The development of gastrointestinal symptom cluster in AP patients was mainly low decline. The development of psychological symptom cluster was mainly high decline. Drinking history and diabetes mellitus were the influencing factors of development trajectory of gastrointestinal symptom cluster in AP patients (P<0.05). High disease severity, drinking history and biliary tract disease were the influencing factors of development trajectory of psychological symptom cluster in AP patients (P<0.05). Conclusion The symptom clusters of AP patients changes over time, with digestive, fatigue, and psychological symptoms being the main groups in the early stage, and psychological and digestive symptoms persisting in the later stage. Early identification and intervention are crucial for improving the prognosis of AP patients.

To evaluate the therapeutic effect of a modified Devine procedure with a subcutaneous sliding fixation method for the treatment of congenital concealed penis, we retrospectively selected 45 patients with congenital concealed penises who were admitted to General Hospital of Ningxia Medical University (Yinchuan, China) between September 2020 and November 2023. In all cases, the penis was observed to be short, and retracting the skin at the base revealed a normal penile body, which immediately returned to its original position upon release. All patients underwent the modified Devine procedure with subcutaneous sliding fixation and completed a 12-week postoperative follow-up. A statistically significant increase in penile length was observed postoperatively, with the median length increasing from 4.0 (interquartile range [IQR]: 3.5-4.8; 95% confidence interval [CI]: 3.9-4.4) cm to 8.0 (IQR: 7.8-8.0; 95% CI: 7.7-7.9) cm, with P < 0.001. The parents were satisfied with the outcomes, including increased penile length, improved hygiene, and enhanced esthetics. Except for mild foreskin edema in all cases, no complications (such as infections, skin necrosis, or penile retraction) were observed. The edema was resolved within 4 weeks after the operation. This study demonstrates that the modified Devine procedure utilizing the subcutaneous sliding fixation method yields excellent outcomes with minimal postoperative complications, reduced penile retraction, and high satisfaction rates among patients and their families.
Humans ; Male ; Penis/abnormalities* ; Retrospective Studies ; Urologic Surgical Procedures, Male/methods* ; Treatment Outcome ; Child ; Plastic Surgery Procedures/methods*

OBJECTIVE: The aim of this study is to evaluate the clinical efficacy of Oxalicao Formula combined　with transacupuncture in the treatment of chronic nonbacterial prostatitis （CNP）characterized by dampness-heat stasis. METHODS: A total of 70 patients diagnosed with CNP and characterized by dampness-heat stasis were randomly divided into control group and treatment group, with 35 cases in each group. The patients in control group received Qianlie Beixi capsules． Ｗhile the patients in　treatment group were administered with oxalis decoction in conjunction with acupuncture therapy　which lasted for 8 weeks. Pre- and post-treatment evaluations for NIH-Chronic Prostatitis Symptom Index (NIH-CPSI), Traditional Chinese Medicine (TCM) symptom scores, urodynamic parameters, immune cell subsets and inflammatory factors were performed. RESULTS: Ultimately, 65 patients completed the study　with 33 in the treatment group and 32 in the control group. After 8 weeks of intervention, The patients in both of groups demonstrated significant improvements (P<0.05). Specifically, remarkable reductions in the NIH-CPSI total score　including pain score, urination score, quality of life impact score, TCM symptom score and inflammatory cytokine levels　were observed. Additionally, there were upward trend　in maximum and average urinary flow rates as well as the CD4+/CD8+ ratio of immune cells(P<0.05). Compared to the control group, the treatment group exhibited superior outcomes in reducing the NIH-CPSI total score, pain score, urination score, quality of life impact score, TCM symptom score, and inflammatory cytokine levels, and increasing in　CD4+/CD8+ ratios， maximum and average urine flow rates(P<0.05). CONCLUSION The combination of Oxalicao Formula and transacupuncture for treating CNP characterized by dampness-heat stasis demonstrates significant therapeutic benefits, which has considerable clinical application value.
Humans ; Male ; Prostatitis/therapy* ; Drugs, Chinese Herbal/therapeutic use* ; Acupuncture Therapy ; Medicine, Chinese Traditional ; Chronic Disease ; Treatment Outcome ; Adult

Miao medicine is guided by the medical theories of the Miao ethnic group, and the drugs used by the Miao people are derived from natural plants and animals for the prevention and treatment of diseases and protection of health. In recent years, a large number of clinical studies have shown good clinical efficacy of traditional Miao medicine in the treatment of prostatic diseases, with the advantages of easy availability, low price, and minimal adverse reactions. However, currently no systematic literature review has been reported on the treatment of prostatic diseases with Miao medicine. This article focuses on the commonly used Miao drugs recorded in the Chinese Materia Medica－Miao Medicine, with a systematic review of relevant literature retrieved on the treatment of prostate diseases with Miao medicine in recent years and a summarization of the advances in the studies of its pharmacological effects, mechanisms of action and clinical application, aiming to provide some new perspectives and ideas for further academic research and clinical development of Miao medicine.
Humans ; Male ; Drugs, Chinese Herbal/therapeutic use* ; Medicine, Chinese Traditional ; Phytotherapy ; Prostatic Diseases/drug therapy*

OBJECTIVE: To evaluate the efficacy and safety of denosumab in the treatment of prostate cancer with bone metastases. METHODS: Relevant studies were retrieved from PubMed, EMBASE, Cochrane, Web of Science, Sinomed , CNKI and Wanfang databases. The Cochrane risk-of-bias assessment tool was used to evaluate the quality of included studies, and relevant data were extracted. meta-analysis was performed using RevMan 5.4 and RStudio software, and forest plots were generated. RESULTS: Six randomized controlled trials (RCTs) were included. Compared with the control group, denosumab significantly reduced the risk of skeletal-related events (HR=0.78, 95% CI: 0.62-0.93). In terms of safety, denosumab did not increase the risk of total adverse events, severe adverse events and the adverse events higher than CTC grade 3. CONCLUSION Denosumab can delay the time to first skeletal-related event with good safety. However, due to the limitations of this study, further high-quality, large-sample, multicenter RCTs are needed to confirm these findings.
Humans ; Denosumab/therapeutic use* ; Bone Neoplasms/drug therapy* ; Prostatic Neoplasms/drug therapy* ; Male ; Randomized Controlled Trials as Topic ; Bone Density Conservation Agents/therapeutic use*

OBJECTIVE: To assess the safety, efficacy and potential impact of stem cell therapy (SCT) in improving erectile dysfunction (ED). METHODS: A comprehensive search strategy was used to search the literatures on safety and efficacy evaluation of stem cell (SC) in the treatment of ED by human clinical trials from PubMed, Embase and Web of science databases with a search time frame from database creation to July 4, 2024. The exclusion criteria were as follows: reviews, conference abstracts, animal experiments, and duplicate sample literature. RESULTS: The study initially screened 1 773 papers, and 17 were included in the final analysis. These studies involved a total of 269 ED patients, and a variety of sources of stem cells had been used in the treatment of ED, including adipose-derived stem cells, bone marrow-derived stem cells, placental stroma-derived stem cells, umbilical cord-derived stem cells, dental pulp-derived stem cells, and oral mucosa-derived stem cells. All studies were conducted by injecting stem cells into the cavernous body of the penis, but there is no fixed standard for the amount of injection, injection site and number of injections. The optimal treatment mode was still being explored. Patients' International Index of Erectile Function (IIEF) scores and Erection Hardness Score (EHS), peak systolic velocity (PSV), and end diastolic velocity (EDV) improved after treatment. But some studies showed that the efficacy of the treatment diminished with increasing time. No serious adverse effects were reported in any of the studies and none of the adverse effects persisted for a long period of time. The most common adverse effects included injection site reactions, and SCT showed a good safety and tolerability profile. CONCLUSION SCT has the potential to be a promising and innovative regenerative therapy option for ED patients. In the future, with the advancement of stem cell technology, larger randomized controlled studies should continue to be conducted to explore standardized treatments, so as to further evaluate the long-term efficacy and safety of SCT for ED.
Humans ; Erectile Dysfunction/therapy* ; Male ; Stem Cell Transplantation/adverse effects* ; Treatment Outcome ; Stem Cells

OBJECTIVE: To evaluate the association between erectile dysfunction (ED) and myocardial infarction (MI) using two sample Mendelian randomization. METHODS: A Mendelian randomization study was conducted using comprehensive data on ED and MI from extensive genome-wide association data. Using inverse variance weighted analysis for causal relationships, and correct for confounding factors using multivariate Mendelian randomization, the potential mediating effects were evaluated as well. Based on Genecard data, the genes related to ED and MI were identified. Molecular docking was used to reveal spontaneously bound drug molecules. RESULTS: Our study found that exposure to ED was a risk factor for MI (OR: 1.001 0, 95% CI: 1.000 2－1.001 8, P=0.017 7), which also held true in the validation dataset (OR: 1.028 5, 95% CI: 1.005 0－1.052 6, P=0.017 2). No statistically significant heterogeneity or horizontal pleiotropy was found. The results of reverse Mendelian randomization analysis showed any reverse causal relationship between ED and MI. In multivariate Mendelian randomization analysis, after excluding confounding factors (excluding triglycerides and high-density lipoprotein), the P-value remained less than 0.05, and the OR ranged from 1.000 1 to 1.000 7, indicating that ED was still a risk factor for MI. In the mediation analysis, it was found that the current mediation ratio of smoking to MI was 13.06%. In summary-data-based mendelian randomization analysis, it was found that the gene PTPN11 was a common target gene for MI and ED (OR=0.990, P<0.001). Subsequent molecular docking with sildenafil, clopidogrel, and dapoxetine could spontaneously bind to the PTPN11 gene receptor. CONCLUSION There is a causal relationship between ED and MI, with smoking as a potential mediating factor, and the gene PTPN11 being a co-target gene.
Humans ; Male ; Mendelian Randomization Analysis ; Myocardial Infarction/genetics* ; Erectile Dysfunction/complications* ; Risk Factors ; Genome-Wide Association Study ; Molecular Docking Simulation ; Polymorphism, Single Nucleotide

Multimodal precision nursing intervention enhances cognitive function and quality of life through multisensory collaborative stimulation by integrating multidimensional data of patients. As one of the most common complications after radical prostatectomy, urinary incontinence seriously affects the quality of life of prostate cancer patients after surgery which has a negative impact on multidimensional health in the "physiological-psychological-social" aspects. This paper summarizes the clinical manifestations, influencing factors, and nursing interventions of urinary incontinence after radical prostatectomy, and focuses on the key points of nursing based on multimodal theory, in order to provide nursing strategies for improving urinary incontinence after prostate cancer surgery.
Humans ; Urinary Incontinence/etiology* ; Prostatectomy/rehabilitation* ; Male ; Prostatic Neoplasms/surgery* ; Quality of Life ; Postoperative Complications/nursing*

BACKGROUND: The association of systemic inflammatory response index (SIRI) with prognosis of coronary artery disease (CAD) patients has never been investigated in a large sample with long-term follow-up. This study aimed to explore the association of SIRI with all-cause and cause-specific mortality in a nationally representative sample of CAD patients from United States. METHODS: A total of 3386 participants with CAD from the National Health and Nutrition Examination Survey (NHANES) 1999-2018 were included in this study. Cox proportional hazards model, restricted cubic spline (RCS), and receiver operating characteristic curve (ROC) were performed to investigate the association of SIRI with all-cause and cause-specific mortality. Piece-wise linear regression and sensitivity analyses were also performed. RESULTS: During a median follow-up of 7.7 years, 1454 all-cause mortality occurred. After adjusting for confounding factors, higher lnSIRI was significantly associated with higher risk of all-cause (HR = 1.16, 95% CI: 1.09-1.23) and CVD mortality (HR = 1.17, 95% CI: 1.05-1.30) but not cancer mortality (HR = 1.17, 95% CI: 0.99-1.38). The associations of SIRI with all-cause and CVD mortality were detected as J-shaped with threshold values of 1.05935 and 1.122946 for SIRI, respectively. ROC curves showed that lnSIRI had robust predictive effect both in short and long terms. CONCLUSIONS SIRI was independently associated with all-cause and CVD mortality, and the dose-response relationship was J-shaped. SIRI might serve as a valid predictor for all-cause and CVD mortality both in the short and long terms.